Sinusitis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 73 of 2018

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting sinusitis or death from sinusitis with the circumstances of a person's relevant service:

1. (1)
   having impaired drainage of the sinus at the time of the clinical onset of sinusitis;

   Note: impaired drainage of the sinus is defined in the Schedule 1 - Dictionary.

2. (2)
   having a viral, bacterial or fungal respiratory tract infection at the time of the clinical onset of sinusitis;
3. (3)
   being in an immunocompromised state as specified at the time of the clinical onset of sinusitis;

   Note: immunocompromised state as specified is defined in the Schedule 1 - Dictionary.

4. (4)
   having a specified medical condition at the time of the clinical onset of sinusitis;

   Note: specified medical condition is defined in the Schedule 1 - Dictionary.

5. (5)
   undergoing a course of therapeutic radiation for cancer, where the nasal cavity and paranasal sinuses were in the field of radiation, before the clinical onset of sinusitis;
6. (6)
   smoking at least one pack-year of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of sinusitis, and: (a) smoking commenced at least one year before the clinical onset of sinusitis; and (b) where smoking has ceased, the clinical onset of sinusitis has occurred within three months of smoking cessation;

   Note: pack-year of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

7. (7)
   being exposed to second-hand smoke: (a) for at least 1 000 hours before the clinical onset of sinusitis; and (b) where the first exposure to second-hand smoke commenced at least one year before the clinical onset of sinusitis; and (c) where the last exposure to second-hand smoke occurred within the three months before the clinical onset of sinusitis;

   Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

8. (8)
   inhaling a drug or irritant substance which results in: (a) acute nasal symptoms or signs within 48 hours of the inhalation; and (b) scarring or erosion of the nasal or sinus mucosa; before the clinical onset of sinusitis;

   Note: Examples of drugs include cocaine, lidocaine, methylphenidate and narcotics.

   Note: Examples of irritant substances include gases (ammonia, chlorine, mustard, nitrogen dioxide, sulphur dioxide), powdered solids (aspirin, baking soda, levamisole, capsules, tablets, pills) and lewisite.

   Note: Examples of acute nasal symptoms or signs include rhinorrhoea, and the inflammation, oedema, ulceration or haemorrhage of the nasal mucosa.

9. (9)
   inhaling airborne dusts, smoke from fires, or fumes or vapours from fuel or a chemical agent within the 48 hours before the clinical onset of sinusitis;
10. (10)
    for sinusitis affecting the maxillary sinus only, having a specified dental condition affecting the tissues adjacent to the affected maxillary sinus at the time of the clinical onset of sinusitis;

    Note: specified dental condition is defined in the Schedule 1 - Dictionary.

11. (11)
    having impaired drainage of the sinus at the time of the clinical worsening of sinusitis;

    Note: impaired drainage of the sinus is defined in the Schedule 1 - Dictionary.

12. (12)
    having a viral, bacterial or fungal respiratory tract infection at the time of the clinical worsening of sinusitis;
13. (13)
    being in an immunocompromised state as specified at the time of the clinical worsening of sinusitis;

    Note: immunocompromised state as specified is defined in the Schedule 1 - Dictionary.

14. (14)
    having a specified medical condition at the time of the clinical worsening of sinusitis;

    Note: specified medical condition is defined in the Schedule 1 - Dictionary.

15. (15)
    undergoing a course of therapeutic radiation for cancer, where the nasal cavity and paranasal sinuses were in the field of radiation, before the clinical worsening of sinusitis;
16. (16)
    smoking at least one pack-year of cigarettes, or the equivalent thereof in other tobacco products, before the clinical worsening of sinusitis, and: (a) smoking commenced at least one year before the clinical worsening of sinusitis; and (b) where smoking has ceased, the clinical worsening of sinusitis has occurred within three months of smoking cessation;

    Note: pack-year of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

17. (17)
    being exposed to second-hand smoke: (a) for at least 1 000 hours before the clinical worsening of sinusitis; and (b) where the first exposure to second-hand smoke commenced at least one year before the clinical worsening of sinusitis; and (c) where the last exposure to second-hand smoke occurred within the three months before the clinical worsening of sinusitis;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

18. (18)
    inhaling a drug or irritant substance which results in: (a) acute nasal symptoms or signs within 48 hours of the inhalation; and (b) scarring or erosion of the nasal or sinus mucosa; before the clinical worsening of sinusitis;

    Note: Examples of drugs include cocaine, lidocaine, methylphenidate and narcotics.

    Note: Examples of irritant substances include gases (ammonia, chlorine, mustard, nitrogen dioxide, sulphur dioxide), powdered solids (aspirin, baking soda, levamisole, capsules, tablets, pills) and lewisite.

    Note: Examples of acute nasal symptoms or signs include rhinorrhoea, and the inflammation, oedema, ulceration or haemorrhage of the nasal mucosa.

19. (19)
    inhaling airborne dusts, smoke from fires, or fumes or vapours from fuel or a chemical agent within the 48 hours before the clinical worsening of sinusitis;
20. (20)
    for sinusitis affecting the maxillary sinus only, having a specified dental condition affecting the tissues adjacent to the affected maxillary sinus at the time of the clinical worsening of sinusitis;

    Note: specified dental condition is defined in the Schedule 1 - Dictionary.

21. (21)
    for sinusitis with nasal polyps only, using a drug belonging to the nonselective (COX-1 and COX-2 inhibitors) nonsteroidal anti- inflammatory class of drugs, at the time of the clinical worsening of sinusitis; (a) includes drugs such as aspirin, diclofenac, ibuprofen, indomethacin, ketoprofen, ketorolac, mefanamic acid, paracetamol, piroxicam and sulindac; and (b) excludes drugs such as celecoxib, etoricoxib, meloxicam and parecoxib;

    Note: Nonselective (COX-1 and COX-2 inhibitors) nonsteroidal anti-inflammatory class of drugs:.

22. (22)
    inability to obtain appropriate clinical management for sinusitis;

Aggravation-only factors: the factors in subsections 9(11) to 9(22) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.